A client is diagnosed with active TB and started on triple antibiotic therapy. What signs and symptoms would the client show if therapy is inadequate?
A. Decreased shortness of breath.
B. Improved chest x-ray.
C. Nonproductive cough.
D. Positive acid-fast bacilli in a sputum sample after 2 months of treatment.
Correct Answer: D. Positive acid-fast bacilli in a sputum sample after 2 months of treatment.
Continuing to have acid-fast bacilli in the sputum after 2 months indicated continued infection. One of the most important aspects of tuberculosis treatment is close follow up and monitoring for these side effects. Most of these side effects can be managed by either close monitoring or adjusting dose. In some cases, the medication needs to be discontinued and second-line therapy should be considered if other alternatives are not available.
Option A: Majority of patients with a diagnosis of TB have a good outcome. This is mainly because of effective treatment. Without treatment mortality rate for tuberculosis is more than 50%. Tuberculosis is a preventable and treatable infectious disease. Having said that, it’s still one of the major contributors of morbidity and mortality in developing countries where we are still struggling to provide adequate access to care.
Option B: DOTS (Direct Observed Therapy) proposed by WHO has been very effective in recent years to improve adherence to the treatment in tuberculosis patients. Also, Vaccination drive in developing countries has played a bigger role in decreasing the prevalence of this infection.
Option C: Preventive effect of BCG vaccination is controversial but many studies have identified vaccination as a very important tool in the fight against tuberculosis and we need to keep our focus on childhood vaccination especially in developing countries.
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